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Please print or write in block letters

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<strong>Please</strong> <strong>pr<strong>in</strong>t</strong> <strong>or</strong> <strong>write</strong> <strong>in</strong> <strong>block</strong> <strong>letters</strong><strong>Please</strong> paste a photo here. (Do NOT staple.)The photo should be clear and identifiable,taken with<strong>in</strong> the last 6 months.<strong>Please</strong> provide the city, state/prov<strong>in</strong>ceand Country <strong>in</strong> which you were b<strong>or</strong>n.<strong>Please</strong> tick the appropriate box.Surname should be capitalized.<strong>Please</strong> <strong>write</strong> <strong>or</strong> select nationality <strong>or</strong> citizenship.<strong>Please</strong> clarify as concrete as possible.<strong>Please</strong> <strong>write</strong>accurately.(Phonenumbers shouldstart from thearea code.)


<strong>Please</strong> <strong>write</strong>accurately.(Phonenumbers shouldstart from thearea code.)In case the applicant has humanitarian reasons shouldbe considered.<strong>Please</strong> tick the appropriate box.In case of an <strong>in</strong>fant, parents <strong>or</strong> a legal representative can signhere. <strong>Please</strong> <strong>in</strong>dicate the relationship.(eg. Signed by mother)

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